ADHD Assessments in the UK: Why the “Right to Choose” System Isn’t Working for Many Patients

Short Summary

Recent Guardian reporting shows that England’s NHS “Right to Choose” pathway for ADHD assessments is causing confusion and delays for many patients. While the policy lets people access NHS-funded private assessments to avoid long waits, some diagnoses are later rejected or not integrated back into NHS care, leaving people stuck and repeating processes. This reflects wider challenges in ADHD services, variable assessment quality, and the need to understand both the benefits and limits of the system.

Long Read

ADHD Assessments in the UK: Why the “Right to Choose” System Isn’t Working for Many Patients

Recent reporting in The Guardian has highlighted serious challenges facing people seeking ADHD assessment and care in England — especially when using the NHS “Right to Choose” system to access private services. The system was intended to reduce long waiting lists, but for many it has become a confusing “grey zone” that leaves people stuck between private diagnosis and ongoing NHS care.

What the “Right to Choose” System Is

Under NHS policy in England, if your GP refers you for ADHD assessment, you can choose any NHS-funded provider approved to offer the service. This includes some private providers that hold NHS contracts. In theory, the NHS pays for the assessment to be done sooner than local NHS waiting lists allow.

However, that’s not where the system’s issues end.

Problems Patients Are Facing

According to the Guardian article, multiple structural issues have emerged:

• Private ADHD diagnoses are sometimes rejected by the NHS — even when funded through “Right to Choose.”

• Some NHS trusts report they are seeing more people return to NHS services after private assessments have stalled, effectively clogging waiting lists.

• There is ongoing concern about variable quality, limited regulation, and unclear oversight of some private ADHD assessment services.

• Workforce shortages and surging demand mean some regions have extremely long waits and heavy pressure on services.

For many people, this means that even after a private ADHD diagnosis via “Right to Choose,” access to medication, shared care arrangements, or ongoing NHS support is uncertain — and in some cases, requires a new NHS assessment.

Why This Matters for You

If you’re considering an ADHD assessment in the UK, it helps to understand the system clearly:

• “Right to Choose” can offer a funded assessment outside local NHS waiting lists, but it isn’t a guaranteed shortcut to ongoing NHS care.

• Not all private assessments are treated the same by all NHS trusts — coverage, acceptance of diagnosis, and shared care arrangements vary.

• You might still face additional NHS assessments or delays for medication prescribing or specialist follow-up.

This contributes to frustration, uncertainty, and sometimes repeated waiting periods — particularly when private assessment reports are not accepted for shared care or treatment pathways.

Tips for Navigating the System

Here are practical things to consider if you’re planning an ADHD assessment:

• Ask your GP for a “Right to Choose” referral — it’s your legal option under NHS policy.

• Check what the provider offers — including prescribing, shared care support, and whether your GP practice accepts diagnoses back into NHS shared care.

• Understand that a diagnosis does not automatically guarantee access to ongoing NHS treatment or medication without further coordination.

Final Thoughts

The issues highlighted in The Guardian reflect wider system pressures: rising demand, stretched NHS services, and inconsistent integration between private and NHS pathways. The “Right to Choose” policy was designed to help, yet its implementation has exposed gaps that leave many patients feeling stuck and unsure where to turn next.

Understanding how the system works — and the limitations that still exist — can help you make informed choices, ask the right questions, and get the most out of any assessment journey you embark on. View the Guardian article here: https://www.theguardian.com/society/2026/jan/24/adhd-nhs-private-providers-right-to-choose